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my:health Women Suraksha is HDFC ERGO's benefit-based health plan for women. Instead of reimbursing hospital bills, it pays a fixed lump sum, as a percentage of your chosen sum insured, when you are diagnosed with a covered illness or undergo a covered procedure after the waiting period. The plan comes in six variants: Women Cancer Plan, Women Cancer Plus Plan, Women Cardiac Plan, Women CI Essential Plan, Women CI Comprehensive Plan and Women Assault & Burns Plan. Cancer cover includes breast, cervix, uterus, fallopian tube, ovary and vagina or vulva. Higher variants add women-specific major illnesses, surgical procedures, cardiac ailments and procedures, and 41 listed critical illnesses. Sum insured ranges from ₹1 lakh to ₹5 crore on an individual basis, and the policy can be taken for 1, 2 or 3 years. Optional covers include pregnancy and newborn complications, post-diagnosis support and loss of job.
A benefit-based plan — pays a lump sum on diagnosis of a covered illness, not a reimbursement plan. Covers 41 critical illnesses including all major women-specific cancers, cardiac ailments, and major surgeries.
my:health Women Suraksha works differently from a regular mediclaim policy, and that is the first thing to understand before buying it. It does not pay your hospital bill. It pays a fixed amount when a covered condition is diagnosed or a covered procedure is done, so it is best read as a financial cushion alongside a hospitalisation plan, not a replacement for one. Its strength is the focus on conditions that matter to women. Malignant cancers of the breast, cervix, uterus, fallopian tube, ovary and vagina or vulva pay 100% of the sum insured at the major stage. Early-stage cancer (carcinoma in situ of the cervix or breast), breast and gynaecological surgeries and some cardiac procedures pay 25% of the sum insured, capped at ₹10 lakh. Because you pick the variant, you can pay for only the cover you want, from cancer only up to the CI Comprehensive Plan with 41 critical illnesses. The trade-offs are structural. Only one claim is payable at each stage, a paid minor-stage claim ends all other minor-stage cover, and a paid major-stage claim ends cover under the illness sections of the policy. Waiting periods are 90 days for major-stage conditions, 180 days for minor-stage conditions and 36 months for pre-existing conditions, and the insured must survive 7 days after diagnosis for a claim to be paid. Regular childbirth costs are not part of the listed covers; only specified pregnancy and newborn complications are covered, through an optional add-on.
HDFC ERGO Health Insurance
Key Insights
Founded
2002
HDFC ERGO Health Insurance was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
97.9% CSR, calculated as a 3-year average
HDFC ERGO Health Insurance settles 97.9% of all claims it receives, demonstrating strong credibility.
Network Hospitals
12,000–14,000
HDFC ERGO Health Insurance has a network of 12,000–14,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Pays 100% of the sum insured on diagnosis of malignant cancer of the breast, cervix, uterus, fallopian tube, ovary or vagina or vulva, and of other major cancers, after a 90-day waiting period.
Available in the Cancer, Cancer Plus, CI Essential and CI Comprehensive variants. Not part of the Cardiac Plan.
Pays 25% of the sum insured, up to ₹10 lakh, on diagnosis of carcinoma in situ of the cervix uteri or of the breast, after a 180-day waiting period.
Covers Systemic Lupus Erythematosus with Lupus Nephritis, Rheumatoid Arthritis and Severe Osteoporosis. Major-stage claims pay 100% of the sum insured after 90 days.
Available in Cancer Plus, CI Essential and CI Comprehensive.
Pays 25% of the sum insured, up to ₹10 lakh, for breast lumpectomy, mastectomy, breast reconstructive surgery, hysterectomy, Wertheim's operation, radical vulvectomy, total pelvic exenteration and complicated repair of vaginal fistula, after 180 days.
Available in CI Essential and CI Comprehensive only.
Major-stage conditions pay 100% of the sum insured after 90 days: open chest CABG, heart valve repair, first heart attack of specified severity, coma of specified severity and stroke with permanent symptoms. Minor-stage procedures (angioplasty, pacemaker insertion, balloon valvotomy or valvuloplasty) pay 25% up to ₹10 lakh after 180 days.
Available in Cardiac, CI Essential and CI Comprehensive.
Pays 25% of the sum insured, up to ₹5 lakh, for pregnancy complications (disseminated intravascular coagulation, ectopic pregnancy, molar pregnancy, eclampsia) and for newborn conditions (Down's syndrome, spina bifida, tetralogy of Fallot, cleft palate, ventricular septal defect, patent ductus arteriosus, surgical separation of conjoined twins). The waiting period is 1 year.
Available with Cancer Plus, CI Essential and CI Comprehensive. Entry age is 18 to 40 and cover is effective up to age 50. A newborn condition must be diagnosed within 2 years of delivery, and the baby must survive 30 days.
Second medical opinion up to ₹10,000, molecular gene expression profiling test up to ₹10,000 (once, on diagnosis of a major-stage cancer), and outpatient counselling of ₹3,000 per session for up to 6 sessions.
Conditions or treatments that the policy clearly says it will not cover.
These are the conditions and procedures the plan pays for. Which ones apply depends on your variant: Cancer Plan covers cancer only; Cancer Plus adds the three major illnesses; Cardiac Plan covers cardiac ailments and procedures; CI Essential covers cancer, major illnesses, surgical procedures and cardiac; CI Comprehensive adds 41 critical illnesses. Major-stage conditions pay 100% of the sum insured after 90 days. Minor-stage conditions pay 25% of the sum insured, up to ₹10 lakh, after 180 days.
Insurer
HDFC ERGO Health Insurance plans and claim process
No. It is a benefit-based plan that pays a fixed lump sum, as a percentage of your sum insured, when a covered illness is diagnosed or a covered procedure is done. It does not reimburse hospital bills, so it works best alongside a regular health insurance policy.
There are six: Women Cancer Plan (cancer), Women Cancer Plus Plan (cancer and major illnesses), Women Cardiac Plan (cardiac ailments and procedures), Women CI Essential Plan (cancer, major illnesses, surgical procedures and cardiac), Women CI Comprehensive Plan (all of these plus 41 critical illnesses) and Women Assault & Burns Plan.
Major-stage conditions pay 100% of the sum insured. Minor-stage conditions pay 25% of the sum insured, up to ₹10 lakh. Only one claim is payable at each stage. A paid minor-stage claim ends all other minor-stage cover, and a paid major-stage claim ends cover under the illness sections of the policy.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official HDFC ERGO Health Insurance website before purchasing.
Contact Details
1800-2700-700
Headquarters: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059, Maharashtra, India
The aforementioned ratios have been averaged over three years (FY24-FY26)
Available as optional covers with the five illness variants. Not available with the Assault & Burns Plan.
Pays a benefit if you lose your job through voluntary resignation or termination because of a covered major-stage illness or procedure.
You must be employed full time at policy start. The benefit table shows up to 50% of monthly salary for up to 6 months.
Pays for death, permanent total or partial disability resulting from assault, and for second or third degree burns, as a percentage of the sum insured set out in the benefit table, after 90 days.
Optional with the five illness variants (over and above base sum insured), or available as the standalone Assault & Burns Plan.
Major-stage conditions have a 90-day waiting period and minor-stage conditions 180 days. Pregnancy and newborn complications have a 1-year wait, and pre-existing conditions 36 months. The insured must also survive 7 days after diagnosis for a claim to be paid.
Regular childbirth costs are not part of the listed covers. An optional add-on pays 25% of the sum insured, up to ₹5 lakh, for four specified pregnancy complications and seven newborn conditions. It is available with Cancer Plus, CI Essential and CI Comprehensive, for entry ages 18 to 40.
Adults can join between 18 and 65 years. For the pregnancy and newborn cover, the entry age is 18 to 40 years.
If a minor-stage claim is paid, HDFC ERGO waives 50% of the annual premium for the insured person who claimed, on renewal, for up to 5 subsequent policy years.
You can add pregnancy and newborn complications, post-diagnosis support (second medical opinion, gene expression profiling test and outpatient counselling), loss of job benefit, and assault and burns cover. Availability depends on the variant you choose.